12 de April de 2024

Preparation for gender-affirming surgery: Recommendations before transgender surgery

At barnaclínic+, we understand the importance and value of taking the step toward gender-affirming surgery. As an essential part of this process, we want to assure you that we are here to provide you with the best care and support at every stage of your journey. Before gender-affirming surgery, proper transgender surgery preparation is essential to ensure a comfortable, safe, and successful experience. Therefore, we have put together a series of tips and recommendations that will help you properly prepare for surgery and take care of yourself during the recovery process. Our commitment is to your well-being, both physical and emotional, and we strive to provide you with the best medical and emotional care in this crucial phase of your life. In this first article of our blog, we will provide you with detailed information on the necessary preparation before gender-affirming surgery, highlighting the importance of following these steps to ensure optimal results. We are always here to answer any questions or concerns that may arise along the way.

Transgender surgery preparation

4-6 weeks before the intervention – STOP SMOKING

When to stop smoking?

The recommended time for stopping smoking before transgender surgery may vary depending on the surgical procedure and individual health factors. Generally, we recommend patients stop smoking for a minimum of four to six weeks before gender-affirming surgery, although some people may be recommended longer periods of time to stop smoking. The longer you can stop smoking before surgery, the better, as it gives your body more time to recover and reduces the associated risks.

Why quit smoking before gender-affirming surgery?

Smoking is associated with an increased risk of surgical complications, such as infections, delayed wound healing, and poor wound healing. Nicotine and other chemicals in cigarettes can constrict blood vessels, reducing blood flow to tissues, which impairs the body’s ability to heal.

Smoking can slow the body’s natural healing processes, which can lead to longer recovery times and a higher risk of post-operative complications after the gender confirmation surgery. Nicotine and other toxins from tobacco can interfere with collagen production and reduce the body’s ability to form strong, healthy scars. This may affect the cosmetic outcome of the transgender surgery.

Smoking can affect the way the body metabolises anaesthesia, which could lead to complications during and after transgender surgery.

3 weeks before the intervention – STOP HORMONAL THERAPY

Why discontinue hormone therapy before gender-affirming surgery?

Hormone therapy can affect blood clotting and increase the risk of blood clots. Temporarily stopping hormone therapy before gender-affirming surgery helps reduce this risk, as blood clotting factors tend to return to baseline levels.

Surgeons prefer to perform transgender surgery when the patient’s body is in a more stable and predictable state. Hormone therapy can affect tissue density and blood flow, which can make surgery more challenging. By stopping hormone therapy before transgender surgery, surgeons can work with tissues that are closer to their natural state.

Hormone therapy can cause increased tissue inflammation and bruising, which can affect surgical results and the recovery process. Stopping hormones before gender confirmation surgery can help minimise these effects.

Discontinuation of hormone therapy allows for a more accurate assessment of your baseline health, which is essential for the surgical team to safely plan and execute the procedure.

Improved healing: After surgery, the body needs to heal and stopping hormone therapy for a period before surgery can promote better healing and recovery. Hormone therapy can potentially interfere with the body’s natural healing processes.

48 hours before the intervention – TAKE THE BOWEL PREPARATION

Why perform bowel preparation before gender-affirming surgery?

The combination of dietary restrictions and laxatives effectively empties the intestines of solid waste and minimises the presence of faecal matter during gender-affirming surgery. This helps create a sterile surgical field, reduces the risk of contamination, and promotes a safer, more successful surgical outcome.

Intestinal bacteria can cause infections when they come into contact with surgical incisions or newly created genital structures. By cleansing the intestines, the risk of infection is minimised.

The surgical team aims to maintain a sterile environment in the operating room. Thorough bowel preparation before transgender surgery helps reduce the risk of faecal contamination during the procedure, which can lead to serious postoperative infections.

Minimising the risk of postoperative infections can contribute to a faster and more complication-free recovery process for the patient. Infections can cause complications that can prolong recovery time.

A clean surgical field can help achieve better cosmetic results by reducing the likelihood of complications that could affect the appearance and function of the newly constructed genitals.

Between 48 and 24 hours before the intervention – FOLLOW THE INDICATED DIET

During the two days before gender-affirming surgery, you must follow a controlled diet, while you carry out intestinal preparation with Citrafleet®. In this sense, during the 48 hours before the transgender surgery you are going to undergo, you can eat protein foods and carbohydrates, however, you will not be able to ingest fibre or fat of any kind. On the other hand, during the 24 hours before gender-affirming surgery, you must follow a strictly liquid diet.